The invention pertains to simple and effective ways to extract and wield alignment data from x-ray or other photographic images for the automated repositioning of external fixators, as needed to align bones during the healing process. In previous uses of external fixators for orthopedic bone alignment and correction, a wide variety of techniques have been used to assist the surgeon in positioning or repositioning the bones using a external fixator. In other words, unlike internal fixation such as screws, plates and intramedullary nails, external fixators provide postoperative adjustability—and there are many ways to make such adjustments. In the situation of limb lengthening, trauma, or deformity correction, gradual manipulation is necessary and possible with frame adjustment. For the most part, postoperative adjustment with external fixators, particularly external ring fixators, has been a manual undertaking, and although the surgeon is generally guided by x-rays or other imaging showing the relative positions of the bones, the calculations of the magnitude of linear translation and angular rotation to affect the adjustment have generally been made by eye and experience. While experience counts for a great deal in health care in general and orthopedics in particular, an automated external fixator ring adjustment system may enhance the surgical outcome directly or indirectly by reducing human error. Automated adjustment based on the x-ray or other imaging, can reduce guesswork, or simplify the manual calculations on the part of the surgeon or other healthcare provider. Going a step further, automating the adjustment process has the potential of manipulating the external fixator without relying on the patient.